Appointment Form 3 – NOTICE OF PRIVACY PRACTICES

    Unique Lingerie, Inc.

    202 SW 17th St. UNIT C

    Ocala FL 34471

    Phone: 352.877.8700

    eFax: 352-608-9718

    Office Fax: 352-421-5592

    Logo of Unique Lingerie, INC. Ocala Florida

    Acknowledgement of Receipt of
    NOTICE OF PRIVACY PRACTICES
    for
    Unique Lingerie, Inc.










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